Hepatitis B Vaccination, Hypothermia, Newborn, Hypoxic-Ischemic Encephalopathy
Conditions
Keywords
Hypoxic Ischemic Encephalopathy, Hepatitis B vaccination
Brief summary
The purpose of the research is to determine if the Hepatitis B vaccine after birth provides enough protection after cooling for Hypoxic Ischemic Encephalopathy (HIE). To do this, Hepatitis B titers (blood sample) would be taken before, during, and after administering of the Hepatitis B vaccine series to measure efficacy of the vaccine.
Detailed description
Despite the current research on Hypoxic Ischemic Encephalopathy (HIE), and the known effects of hypothermia on acute immune response, the effect of the hypothermia protocol for HIE on the efficacy of the Hepatitis B vaccine is still unknown. We plan to measure anti-hepatitis B surface antibodies at intervals prior, during, and after the primary Hepatitis B vaccine schedule for individuals with HIE to see if there is any effect on efficacy due to the Hypothermia protocol.
Interventions
OTHERHypothermia Protocol
Subject's who will be treated with the hypothermia protocol for Hypoxic Ischemic Encephalopathy as standard of care.
Sponsors
Medical University of South Carolina
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
0 Hours to 72 Hours
Healthy volunteers
No
Inclusion criteria
* \> 34 weeks' gestation at birth as measured by best obstetrical estimates * \> 1500 grams birth weight * Clinical signs of asphyxia or documented periods of hypoxic ischemia with no cyanotic cardiac malformations and no known congenital infections. * Documented period of hypoxic ischemia: * Venous Cord gas pH \< 7.0 or initial newborn blood gas pH \< 7.1 * Base deficit \> 13 on venous cord gas or initial newborn blood gas * Apgar score \< 5 at 10 minutes * Prolonged, sustained fetal bradycardia (HR \<80) for \> 15 minutes in utero by doppler or fetal heart rate monitoring * Need for continued resuscitation after 5 minutes (bag-valve mask ventilation with/or without chest compressions) due to the absence of respiratory effort * Documented postnatal oxygen saturation \< 70% or PaO2 \< 35 for \> 20 minutes by 2 ABGs, not due to cyanotic heart disease, accompanied by hypotension (mean BP\< 35), cardiac arrest with chest compressions, or hemorrhage (requiring 20cc/kg volume replacement) * Parental willingness for infant to receive Hepatitis B vaccine.
Exclusion criteria
\- Positive maternal Hepatitis B status during pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Determine efficacy of the Hepatitis B vaccine in individuals who are treated with routine care of Hypothermia for Hypoxic Ischemic Encephalopathy | 18 months | Response to vaccine will be measured by the previously researched protective level of anti-hepatitis B surface antibodies of ≥ 10 mIU/ml. We hypothesize that hypothermia to 33-33.5oC for 72h in near-term and term infants with Hypoxic Ischemic Encephalopathy will decrease the infant's immune response to the primary Hepatitis B vaccine series. |
Countries
United States
Outcome results
None listed